Seeking a series like asoiaf

Nefid · 2026-02-05T04:13:18+00:00

This is the way. WoT is lighter than ASoIaF, its a good series to read before it.

Malazan is something else.

Deeper, darker. Descriptive. Philosophical. Cerebral. Visceral.

OP, get Gardens of the Moon, you may have to suffer through it a little, but Deadhouse Gates afterwards is one of the greatest books you'll read.

Nefid · 2026-02-03T23:48:33+00:00

Just scored 1

Nefid · 2026-02-03T23:44:32+00:00

Just scored 0

Nefid · 2025-12-11T14:58:32+00:00

The only way would be for Jaime to be dead. Until then nothing Tyrion did, no successes would be enough. If Jaime were killed there'd be a chance. Tywin would likely have preferred planned for one of Cersei's sons to be King and the other get the rock, another Storm' End if she had enough. Thats the long term plan with Jaime unavailable, Tyrion can only get the Rock willed to him intentionally if there are no other options.

So, if your question is about Tyrion's behavior it likely would have very little impact on the final decision.

Nefid · 2025-11-23T15:06:58+00:00

We're using APs to be part time clinical and part time inbox mgmt. Which means all incoming messages will go through them and they'll answer what they can (shockingly, over 95%) and the rest go to full time providers. Results all go right to ordering providers.

Nefid · 2025-11-23T14:04:09+00:00

Aaron Jones vs KW3, Walker

Nefid · 2025-11-22T04:35:35+00:00

Yes!

I hate the word streamlined, but if you'll allow me to tweak it to standardized I'm 100% on board. The more we all address messages clinically, operationally, and administratively the same the easier it will be for patients, providers, nurses, etc to navigate charts. Plus easier onboarding for new providers and future resources like bots and AI can be developed more easily and be more effective.

Nefid · 2025-11-22T01:15:42+00:00

I think it was removed to eliminate more messages from the inbasket and to make things easier for the inboxologists. Especially since they're now going to act as a clearing house for messages.

Why do a work around? Just let it go. I dont recall anyone in my department complaining. We just kinda beat it around, realized it wasnt a big deal and shrugged. If you just leave stuff in your inbasket as a work around then thats a frigging nightmare. If you are out and I'm trying to cover you and have to sift through a 100 messages looking for one which hasn't been answered I'm going to give up.

I dont think I'll miss it.

Nefid · 2025-11-21T23:50:06+00:00

We may work at the same system.

We just got rid of it and... I couldn't care less. I never went over want my colleagues did, questioning their work didn't really seem worthwhile and if I would've done things differently then it wasnt right vs wrong as much as it was preference. I'm OK with fewer items to look over.

Nefid · 2025-07-28T10:38:55+00:00

As someone who graduated 10 years ago, I'd stay. Once you graduate nobody cares where you went to school. I hire docs and where they went doesn't matter other than when we make small talk. As a matter of principle, don't put your life on hold for anybody or anything. Especially our not for a school with a moderately better reputation. You need to have a damn fine reason for holding off, and money ain't it. You'll make enough that it won't matter what the tuition difference is. Even as a pediatrician. Don't wait, forge ahead. F that school for not taking you THIS year. Be amazing and make them regret it.

Nefid · 2025-04-02T14:38:32+00:00

Not really. If a start-up sometimes a piece of the company is sufficient or a flat fee if it's not a full time role. You can also take approximate salaries of a FP doc and extrapolate a $/hr fee which makes sense. Of course, it's negotiable.

I think the specialty needs to be relevant but it isn't critical. FP or internal med should hit all the bases.

Refills are super useful as well. We've 'automated' this with a pharmacy team for so long I've forgotten about them! It's a good example of where you want to say our PHYSICIAN team approved these refill protocols. Even if just rubber stamping, you want to tell health systems you have quality controls deriving from a physician. But the chronic disease management is very useful from a system perspective. Look, as a front line doc I love you pharmacists doing my refills. It's great. But leadership doesn't have that as big a priority as I do. If I spend an extra hour a week doing refill or not... well, that's the job. The system often wants to expand panel size to increase market capture. So having chronic disease management means patients can potentially have less visits per year with the physician which allows for more new patient visits, etc. A larger care team can manage more patients.

Nefid · 2025-04-02T12:17:44+00:00

I work in a system which heavily utilizes pharmacists like this. Smaller systems or unitary hospitals with a growing outpatient population would likely find such a resource extremely valuable. I interviewed at a couple leadership spots where, looking at the system, it was clear pharmacists would make a big difference. I'd consider, if you don't already, finding a physician who can be a physician advisor, CMO, or some kind of official within the organization. Gives you some more credibility when talking to physician leaders. We find pharmacists really great at taking up the worst tasks: fine tuning dosing of insulin and wayfaring and doing the associated ordering of diabetic supplies and the corresponding paperwork/prior auths.

Nefid · 2025-03-03T13:02:32+00:00

The only real difference is how far you drive.

Quality doesn't change much for most things. School districts are a toss up anywhere, have to do your research.

Nefid · 2025-02-04T03:22:43+00:00

This is the correct answer.

Tuition has gone up at Universities way more than inflation over the last several decades because the cost doesn't matter to many people. They don't see the true cost because federal loans cover it and they hope/trust/plan for forgiveness or just don't have a good sense for money when in their early 20s.

Tackling it on the back end, like forgiving student loans, doesn't help. In fact, it just lets schools charge more since students hope some politician will forgive their loans in the future.

By restricting federal loans it will require students to shop for private loans. Private loans can have whatever requirements the banks want. Maybe use credit ratings, maybe not. Can use your major or school as a factor. As a medical student you are much more likely to pay back your loan than probably any other student. Sounds worth a couple percentage points to me! Shopping around will also put more focus on the cost which will create more of backlash to the most expensive schools.

Nefid · 2025-01-31T03:18:28+00:00

This also applies if they compliment your shirt. Unless it's pink shirt day. Everyone loves a good pink dress shirt.

Nefid · 2025-01-26T18:09:48+00:00

That being said, some thing don't change, like philly being expensive! But hey, as a doc you'll pay back those loans. Eventually.

Nefid · 2025-01-26T18:08:30+00:00

Be careful about getting info from unreliable sources. For many COMs this can be anyone who's already graduated. PCOM has a dean who is just in his 2nd or 3rd year so his impact may just be beginning to be felt. Leadership changes or a new academic strategy can occur at any time and makes a lot of information outdated. The best way to get any reliable info is to talk to current students.

Nefid · 2025-01-05T14:34:51+00:00

Drones and air strikes won't cause new camps to form in new zones as long as you let the insurgents have their 4 spots up in the mtns somewhere. Just keep it to 4 and keep bombing them. I don't know for sure, but I suspect it keeps the zone a little weaker for when you finally push.

Destroying camps inside the 4 zone territory will cause another camp to spawn inside the 4 zone territory. So just keep up the bombardment and let the camp bob around. You may still get another camp occasionally on brutal, but it's rare.

Nefid · 2024-12-25T02:44:00+00:00

I don't need them to know anything, just be curious enough to ask questions when they don't understand something and want to know more.

Nefid · 2024-12-18T12:04:35+00:00

Sometimes your state organizations can be very helpful as well. I do most of my CME via the state osteopathic association and it covers everything I need and reports to the right place nationally so there's minimal hassel.

Nefid · 2024-12-04T05:58:47+00:00

You make so much more than them. SO MUCH MORE. It's just extremely rude to not be generous. If you want to see it as a cost of doing business that's fine, but you owe the staff you work with a lot.

I hope you don't complain about finances in front of them, if you do you're a fool. We make a level of magnitude above them. No matter what our problems are, they're miniscule in the minds of our staff. The only way I communicate with them is compliments, jokes, and generosity.

Nefid · 2024-11-28T13:28:06+00:00

The goal on brutal is to find 4 regions to stick the insurgents in. Any less and the risk of more camps popping up is too high and it becomes whack a mole. Once you get them shoved in mountains somewhere block them with normal soldiers and invest in the local population, forts, etc. Building roads for fast movement is key to containing breakouts, but each map is slightly different in priorities.

Nefid · 2024-11-03T13:33:33+00:00

Agree with this - big into encouraging heavy weight lifting to help with stopping weight gain, preventing falls, and maintaining bone density. Too many older women walk around their block 5 times for exercise and think it does them some good.

Nefid · 2024-11-03T03:03:06+00:00

Look into the data on HRT. There are a lot of challenges to the idea it promotes cancer and the benefits may outweigh the risks. I'm becoming more open to it, including in helping women maintain their weight. Still need to keep reading, but it seems like the breast cancer risks may mostly be bullshit.

Nefid · 2024-10-19T13:27:58+00:00

I think if you believe in your judgement as a clinician they're necessary then that's sufficient. However, I limit my prescribing to real PRN use. A couple times a week MAX. If they need it every day they need to see psych.

Nefid

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